Provider First Line Business Practice Location Address:
309 E FARWELL RD
Provider Second Line Business Practice Location Address:
204
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-8207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-385-0600
Provider Business Practice Location Address Fax Number:
509-466-4798
Provider Enumeration Date:
01/03/2011